\u200b\u200bIf your pharmacy is informed by a wholesaler that a medicine is out of stock, this may indicate a bigger medicines shortage. To try and preserve continuity of a patient\u2019s medicines wherever possible, have you\u2026<\/p>\n\n\n\n
If you have followed these steps with no success, then please check the\u00a0NHS Lothian Primary Care and Community Pharmacy Shortages\u00a0webpage <\/a>to see if this already a known shortage. If it\u00a0isn\u2019t\u00a0already a known shortage, it\u2019s really important you report this immediately through two main channels:<\/p>\n\n\n\n When reporting medicine shortages, please include:<\/p>\n\n\n\n The NHS Lothian Shortages team will investigate the suspected shortage. They will respond within a few working days to confirm the shortage or to provide any relevant information about availability. The shortages team are unable to provide individual advice on suitable alternatives.<\/p>\n\n\n\n If the shortage is confirmed by the NHS Lothian Shortages team, and the item is Specialist Initiation or requires review by a Specialist in Secondary Care, ONLY THEN should you contact the secondary care shortages team to alert them and allow them to escalate if necessary: loth.medicineshortagesteamsc@nhs.scot<\/a>.<\/p>\n\n\n\n The PMR endorsement can be applied when you have used information from your own records to dispense a suitable alternative without contacting the prescriber or writing a CPUS. Examples include:<\/p>\n\n\n\n Both of these scenarios can be dealt with by adding the PMR endorsement to the prescription both electronically and on the paper copy.<\/p>\n\n\n\n The Prescriber Contacted (PC) endorsement can be applied when you have contacted the prescriber to discuss and agree the change you wish to make. Apply the endorsement electronically and to the paper copy. Examples include:<\/p>\n\n\n\n You should not use a PC endorsement to switch from generic to brand, or brand to brand – this would require a new prescription.<\/p>\n\n\n\n PC endorsements are not appropriate where any change would require further monitoring – for example, drugs with a narrow therapeutic range.<\/p>\n\n\n\n If you are unable to dispense a suitable alternative and you therefore need to return the script to the prescriber, you should attach the NHS Lothian \u2018Out of Stock (Alternative Medicine Request)\u2019 form (see Useful Resources below) to the script when returning it. It is really helpful to include suggestions of available alternative medicines. <\/p>\n\n\n\n Please ensure that you have exhausted the options above before returning the prescription to the prescriber for an alternative.<\/p>\n\n\n\n NHS Lothian Shortages Page (you may need to ask your IT support team to whitelist this web address if you cannot see it): Out of Stock (Alternative Medicine Request) form template<\/a> which pharmacies can send to GP surgeries<\/p>\n\n\n\n dm+d<\/a> is a useful resource to check status of products, who the manufacturers are and what alternatives there are<\/p>\n\n\n\n Specialist Pharmacy Services<\/a> (SPS) shortages page have regular updates on shortages monitored by Department of Health and Social Care (DHSC) including MSNs (issued by English Government) and MSANs (issued by Scottish Government) \u2013 you will need to register for an account which is free <\/p>\n\n\n\n Nutricia Oral and Enteral Nutrition<\/a> weekly stock update, includes stock available from HomeCare services – sign up to their email mailing list to receive their weekly update<\/p>\n\n\n\n British Menopause Society<\/a> gives information on HRT availability and some advice on alternatives and switching<\/a>. <\/p>\n\n\n\n TRAVAX<\/a> website gives updates on travel vaccine availability<\/p>\n\n\n\n SHOW website<\/a> displays Medicine Supply Alert Notices (MSANs) released from Scottish Government <\/p>\n\n\n\n Serious Shortage Protocols<\/a> currently active within NHS Scotland<\/p>\n\n\n\n Government Drug Safety<\/a> updates can be sent directly to your inbox – click \u201cGet Email\u201d at the bottom<\/p>\n\n\n\n Boots Pharmacy<\/a> have launched an online stock checker (only Boots stores and not a guarantee of availability)<\/p>\n\n\n\n\n
\n
Two possible ways you can still dispense medicine for the patient<\/h2>\n\n\n\n
1) PMR Endorsing<\/h3>\n\n\n\n
\n
2) Prescriber Contacted Endorsing<\/h3>\n\n\n\n
\n
Returning Prescription to the Prescriber<\/h2>\n\n\n\n
Useful Resources<\/h2>\n\n\n\n
http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/PharmacyServices\/Medicines%20Shortages\/Pages\/default.aspx<\/a>. <\/p>\n\n\n\n